By Dr. Ali Saleh. Accident: An unplanned event that may or may not result in damage, loss or injury. Injury: Damage to the body resulting from a delivery.

ByDr. Ali Saleh

Accident: An unplanned event that may or may not result in damage, loss or injury.

Injury: Damage to the body resulting from a delivery of energy to the body above the capacity of the body to cope with that energy or an interference with the normal function and systems within the body.

Hazard: any thing or any condition which has the

potential to cause injury or harm to health. a source of potentially damaging energy. a situation with the potential for harm to

life, health and property.

Safety: An individual’s perception of risk. Or a state of mind whereby workers are made

aware of the possibility of injury at all times. Or

a state in which the risk of harm (to persons) or damage is limited to an acceptable level

Risk: the probability that an event may occur

resulting in personal injury or loss to the organization

the probability that a hazard is realized, i.e. leads to an untoward event

the measure of how likely it is that injury will occur in a given situation.

Health and safety: is about preventing people from being harmed at work, by taking the right precautions and by providing a satisfactory working environment.

Nobody chooses to get hurt at work Working safely and efficiently will often

save money Fatal accidents Non-fatal accidents Illness Putting other peoples ’ lives and health at

risk is not acceptable

Amount of time at work Captive audience

◦ subject to powerful pressures from peers & employer to engage in healthy behaviors

Risks for health problems Motivation to maintain health to ensure

their continued ability to work Health promotion efficient and cost-

effective

Visible costs◦ Costs of poor health

Sickness Absenteeism Employee turnover

Invisible costs◦ Low productivity◦ Poor-quality work◦ Poor customer services◦ Accidents◦ Legal claims related to illness and injury

Goal of occupational health services Ensure working adults reach and maintain

full working potential◦ Health promotion◦ Protection◦ Surveillance activities

Or To secure a safe & healthy environment &

enhance the employees’ ability to work.

They occur at three levels: Individual

◦ Health knowledge & skills◦ Individual health status

Community◦ Community norms, awareness, attitudes, practices, &

behaviors System

◦ Organizations & social structures

American Association of Occupational Health Nurses defined occupational health nursing as:

“The specialty practice that focuses on promotion , protection ,& restoration of health within the context of a safe & healthy work environment . It includes the prevention of adverse health effects from occupational & environmental hazards. It provides for & delivers occupational & environmental health & safety programs & services to clients”.

Standard 1. Assessment

Standard 2. Diagnosis

Standard 3. Outcome Identification

Standard 4. Planning

Standard 5. Implementation

Standard 6. Evaluation

Standard 7. Resource Management Standard 8. Professional Development Standard 9. Collaboration Standard 10. Research Standard 11. Ethics

Employee-centered functions: health promotion , protection, illness prevention activities; primary care for health related conditions; crises care; rehabilitation ;& counseling, adaptation of work to the capabilities of workers

Workplace & work community-centered functions: workplace surveillance & hazard detection, as well as communicating risk information to employees & employers, maintaining first aid skills of employees

Collaborative functions: cooperation with other members of occupational health team

Administrative functions: tracking

workers’ compensation cases and cost – benefit analyses

Assessing health in Work setting Planning nursing care in working settings Implementing health care in work settings Evaluating health care in work settings

Biophysical considerations1. Maturation & Aging

◦ Young adult risks: injury related to limited experience.

◦ Older adult risks injury and death related to decreased

Musculoskeletal capacity and sensory impairments. Discrimination in the workplace

2. Genetic Inheritance: factors related to race and gender◦ The gender composition affects the type of health

conditions seen e.g pregnancy

3. Physiologic Function Injury and illness

◦ Acute and chronic illnesses◦ Exposure to factors in work settings.◦ Hospital contributed to most occupational

illnesses related to health care industry.◦ Cancer related to workplace.

Immunization level

Illnesses not related to work but can be worsen by work e.g. arthritis.

Asthma Cardiovascular diseases Reproductive problems Neurotoxic conditions Noise induced hearing loss Infectious diseases Dermatologic conditions Work related injuries Musculoskeletal injuries

Stress in the workplace Mental health and illness in the

workplace◦ Depression→ heart diseases, high cholesterol,

hypertension◦ Schizophrenia◦ Substance abuse◦ Increased cost for both employee and employer◦ Employers are not permitted to ask about

psychiatric illness in hiring decision, and employees are not required to disclose such diagnoses unless they are requesting accommodations.

Indicators for psychological problems◦ Increased absenteeism◦ Mood changes and changes in relationships with

others◦ Increased incidence of minor accidents on and off

the job◦ Complaints of fatigue, weakness, or a general

decrease in energy.◦ Sudden weight loss or gain◦ Increased blood pressure.◦ Frequent stress related illnesses

Type of work settings Examples of hazards

◦ toxins◦ Radiation◦ Noise◦ Vibration◦ Exposure to heat and cold◦ Electrical and magnetic field hazards◦ Fire◦ Heavy lifting and uncomfortable working positions◦ Potential for falls◦ Exposure to metallic compounds, allergens, molds◦ Equipments in workplace

These sociocultural factors affects health status and employee productivity:◦Quality of social interactions among

employees◦Attitudes toward work and health◦The presence or absence of racial or

other tensions

Policy and Legislation◦Occupational Safety and Health Act of

1970 (OSHA)◦Worker’s compensation◦The Americans with Disabilities Act◦Other local and business -specific policies

and regulations

Work and family Non standard wok schedules (e.g. nights or

evening)◦ Effects on partner and children (emotional and behavioral

problems)◦ Adjustments and coping abilities on rotating shifts

Women are more influenced by interrelationships between work and family than men (more responsibilities) .

Work and Family (cont) Occupational injuries and illnesses affects

family also. Para occupational exposure: employees

are exposed to hazardous substance and in turn expose their families.

Workplace Violence

Other sociocultural factors affecting health: Other sociocultural factors affecting health: 1.1. Health related behaviors of employees themselvesHealth related behaviors of employees themselves2.2. Groups of coworkers behaviorsGroups of coworkers behaviors3.3. Management sphereManagement sphere4.4. Legal, social, and political actionsLegal, social, and political actions5.5. Languages spoken and cultural beliefs and Languages spoken and cultural beliefs and

behaviorsbehaviors6.6. Social capital (the value of Social capital (the value of social relations and the and the

role of cooperation and confidence to get resultsrole of cooperation and confidence to get results )7.7. Immigration status Immigration status

Type of work performed (also Multiple jobs) Consumptions patterns

◦ Food and nutrition◦ Smoking◦ Drug and alcohol use

Rest and exercise e.g Night shift, Work that needs too much sitting.

Use of safety devices Working while ill (sickness presenteeism)

The external system considerations: the availability and accessibility of healthcare services outside the workplace

Insurance coverage The internal system (health services and programs

provided in work settings)◦ Programs to control toxic exposures◦ Health promotion programs◦ Comprehensive programs (awareness, lifestyle

change, change in environmental conditions)◦ Family care programs

Primary Prevention◦Health promotion◦Illness prevention◦Injury and violence prevention

Health Promotion Exercise programs Stress management Reproductive health education and referral

servicesIllness Prevention Immunization Risk factor modification Postexposure prophylaxis: treating

communicable diseases after exposure. Stress reduction/management education

Injury Prevention Safety education Make provisions and effective use of safety

equipment Develop policies and procedures that

prevent injury Modify or eliminate injury risk factors in the

work setting Develop adequate management support for

injury prevention policies and procedures

Secondary prevention◦Screening and surveillance

Preemployment screening Periodic screening Environmental screening

◦Treatment of existing conditions Employee assistance program (EPA): to

counsel employees with psychological problems and assist them dealing with these problems

◦Emergency response: planning physical and psychological emergencies.

Tertiary Prevention◦Prevent the spread of communicable

diseases◦Prevent recurrence of acute health

problems◦Prevent complication of chronic

conditions◦Assess fitness to return to work